Unique Effects of Perceived Neighborhood Physical Disorder and Social Cohesion on Episodic Memory and Semantic Fluency

Moderating Role of Neighborhood Environment in the Associations Between Hearing Loss and Cognitive Challenges Among Older Adults: Evidence From US National Study

This study examined the associations between hearing loss and cognitive challenges among community-dwelling older adults and whether neighborhood characteristics (physical disorder and low social cohesion) moderated the associations. Cross-sectional national data from Round 11 of the National Health and Aging Trends Study were adopted (N = 2,515). Multinomial logistic regressions were used to examine associations among variables and interactive analyses were conducted to examine moderating effects. Results indicated significant relationships between the experience of hearing loss and possible dementia and between severe or profound hearing loss and probable dementia. Interactive models suggested that residing in neighborhoods with physical disorder and low social cohesion were negatively associated with possible dementia among older adults with moderate and severe or profound hearing loss, respectively, compared to those without hearing loss. Findings underscore the necessity of environmental and social interventions to enhance cognitive health among older adults with varying degrees of hearing challenges.

An exploration of neighborhood characteristics, psychosocial resilience resources, and cognitive functioning among midlife and older black adults

OBJECTIVES

While existing research has shown that Black adults have worse cognitive functioning than their White counterparts, the psychosocial correlates of cognitive functioning for Black older adults are understudied. The objective of this study was to investigate the relationships among perceived neighborhood characteristics, psychosocial resilience resources, and cognitive functioning among midlife and older Black adults.

METHODS

Data were from 3,191 Black adults ages 51+ in the 2008-2016 waves of the Health and Retirement Study to examine associations among neighborhood characteristics, psychosocial resilience (sense of purpose, mastery, and social support), and cognitive functioning among Black adults. Multilevel linear regression models assessed direct effects of neighborhood characteristics and psychosocial resources on cognitive functioning. We then tested whether psychosocial resources moderated the association between neighborhood characteristics and cognitive functioning.

RESULTS

Mean levels of cognitive functioning, sense of purpose, social support, and mastery were significantly related to neighborhood disorder and discohesion. Regression results showed that levels of neighborhood disorder and high discohesion were significantly associated with cognitive functioning. Sense of purpose was positively associated with cognitive functioning, net of neighborhood characteristics. However, only social support moderated the association between neighborhood discohesion and cognition.

CONCLUSIONS

These findings demonstrate the importance of examining psychosocial and contextual risk and resilience resources among midlife and older Black adults. This work may inform the development of cognitive behavioral interventions aimed at increasing sense of purpose to promote and enhance cognitive resiliency among Black adults. Altogether, this work may have implications for policy aimed at advancing cognitive health equity.

Perceived but not objective measures of neighborhood safety and food environments are associated with longitudinal changes in processing speed among urban older adults

BACKGROUND

Although a growing body of literature documents the importance of neighborhood effects on late-life cognition, little is known about the relative strength of objective and subjective neighborhood measures on late-life cognitive changes. This study examined effects of objective and subjective neighborhood measures in three neighborhood domains (neighborhood safety, physical disorder, food environments) on longitudinal changes in processing speed, an early marker of cognitive aging and impairment.

METHODS

The analysis sample included 306 community-dwelling older adults enrolled in the Einstein Aging Study (mean age = 77, age range = 70 to 91; female = 67.7%; non-Hispanic White: 45.1%, non-Hispanic Black: 40.9%). Objective and subjective measures of neighborhood included three neighborhood domains (i.e., neighborhood safety, physical disorder, food environments). Processing speed was assessed using a brief Symbol Match task (unit: second), administered on a smartphone device six times a day for 16 days and repeated annually for up to five years. Years from baseline was used as the within-person time index.

RESULTS

Results from mixed effects models showed that subjective neighborhood safety (β= -0.028) and subjective availability of healthy foods (β= -0.028) were significantly associated with less cognitive slowing over time. When objective and subjective neighborhood measures were simultaneously examined, subjective availability of healthy foods remained significant (β= -0.028) after controlling for objective availability of healthy foods. Associations of objective neighborhood crime and physical disorder with processing speed seemed to be confounded by individual-level race and socioeconomic status; after controlling for these confounders, none of objective neighborhood measures showed significant associations with processing speed.

CONCLUSION

Subjective neighborhood safety and subjective availability of healthy foods, rather than objective measures, were associated with less cognitive slowing over time over a five-year period. Perception of one's neighborhood may be a more proximal predictor of cognitive health outcomes as it may reflect one's experiences in the environment. It would be important to improve our understanding of both objective and subjective neighborhood factors to improve cognitive health among older adults.

Underlining neighbourhood perception: a possible risk factor for dementia that deserves more attention

This essay highlights the interplay between the neighbourhood structural environment and neighbourhood perceptions on dementia by articulating how an individual's perception of neighbourhood, with respect to their individual differences, may provide key insights to understand the link between the neighbourhood and dementia.

A Scoping Review of Neighborhoods and Cognitive Health Disparities Among US Midlife and Older Adults

Objectives: The neighborhood environment may be an important determinant of racial/ethnic disparities in cognitive function. To understand how neighborhoods are linked to cognition across racial/ethnic groups, this scoping review organizes research investigating relationships between multiple neighborhood domains and cognitive function in diverse samples of US midlife and older adults. Methods: PubMed/MEDLINE, Web of Science, and CAHL were used to extract quantitative disparities-focused studies (n = 17) that included US adults ages 50+, racial/ethnic minoritized populations, cognitive dependent variable(s), and neighborhood-level independent variable(s) published from January 2010 to October 2021. Results: Studies demonstrate variation within and between racial/ethnic groups in how neighborhood factors are associated with cognition. Economically and socially advantaged neighborhoods were associated with better cognition. Findings were mixed for built and neighborhood composition measures. Discussion: More research with greater racial/ethnic representation is needed to disentangle which aspects of the neighborhood are most salient for specific cognitive function domains across diverse populations.

A Framework for Assessing the Effects of Climate Change on Dementia Risk and Burden

Alzheimer's disease and related dementias (ADRD) represent a public health crisis poised to worsen in a changing climate. Substantial dementia burden is modifiable, attributable to risk rooted in social and environmental conditions. Climate change threatens older populations in numerous ways, but implications for cognitive aging are poorly understood. We illuminate key mechanisms by which climate change will shape incidence and lived experiences of ADRD, and propose a framework for strengthening research, clinical, and policy actions around cognitive health in the context of climate change. Direct impacts and indirect risk pathways operating through built, social, interpersonal, and biomedical systems are highlighted. Air pollution compromises brain health directly and via systemic cardiovascular and respiratory ailments. Flooding and extreme temperatures constrain health behaviors like physical activity and sleep. Medical care resulting from climate-related health shocks imposes economic and emotional tolls on people living with dementia and caregivers. Throughout, inequitable distributions of climate-exacerbated risks and adaptive resources compound existing disparities in ADRD incidence, comorbidities, and care burden. Translational research, including work prioritizing underserved communities, is crucial. A mechanistic framework can guide research questions and methods and identify clinical- and policy-level intervention loci for prevention and mitigation of climate-related impacts on ADRD risk and burden.

Effects of neighborhood built environment on cognitive function in older adults: a systematic review

BACKGROUND

In the background of an aging population, the risk of cognitive impairment in the older population is prominent. Exposure to complex neighborhood built environments may be beneficial to the cognitive health of older adults, and the purpose of this study was to systematically review the scientific evidence on the effects of neighborhood built environments on cognitive function in older adults.

METHODS

Keywords and references were searched in Web of Science, Pubmed, PsycINFO, and MEDLINE. Studies examining the relationship between the built environment and cognitive function in older adults were included. The neighborhood built environment as an independent variable was classified according to seven aspects: density, design, diversity, destination accessibility, public transportation distance, blue/green space, and built environment quality. The cognitive function as the dependent variable was classified according to overall cognitive function, domain-specific cognitive function, and incidence of dementia. The quality of the included literature was assessed using the National Institutes of Health's Observational Cohort and Cross-Sectional Study Quality Assessment Tool.

RESULTS

A total of 56 studies were included that met the inclusion criteria, including 31 cross-sectional studies, 23 longitudinal studies, 1 cross-sectional study design combined with a case-control design, and 1 longitudinal study design combined with a case-control design. Most of the studies reviewed indicate that the built environment factors that were positively associated with cognitive function in older adults were population density, street connectivity, walkability, number of public transportation stops around the residence, land use mix, neighborhood resources, green space, and quality of the neighborhood built environment. Built environment factors that were negatively associated with cognitive function in older adults were street integration, distance from residence to main road. The relationship between residential density, destination accessibility, and blue space with cognitive function in older adults needs to be further explored.

CONCLUSION

Preliminary evidence suggests an association between the neighborhood built environment and cognitive function in older adults. The causal relationship between the built environment and cognitive function can be further explored in the future using standardized and combined subjective and objective assessment methods, and longitudinal or quasi-experimental study designs. For public health interventions on the cognitive health of older adults, it is recommended that relevant authorities include the neighborhood built environment in their intervention programs.

Neighborhood Cohesion Across the Life Course and Effects on Cognitive Aging

OBJECTIVES

Greater neighborhood cohesion is associated with better cognitive function in adulthood and may serve as a protective factor against cognitive impairment and decline. We build on prior work by examining the effects of perceived neighborhood cohesion across the life course on level and change in cognitive function in adulthood.

METHODS

Utilizing longitudinal data from the Health and Retirement Study (1998-2016) and its Life History Mail Survey, we leveraged data from 3,599 study participants (baseline age: 51-89) who participated in up to 10 waves. Respondents provided retrospective ratings of neighborhood cohesion at childhood (age 10), young adulthood (age at the first full-time job), early midlife (age 40), and concurrently at baseline (i.e., late midlife/adulthood); they completed the modified version of the Telephone Interview for Cognitive Status. We fit a univariate latent growth curve model of change in cognitive function across waves and tested whether neighborhood cohesion during each recollected life stage predicted level and change in cognitive function.

RESULTS

Greater neighborhood cohesion during childhood and late midlife/adulthood each predicted higher cognitive function at baseline but not the rate of cognitive decline. The final model showed that greater neighborhood cohesion in childhood and in late midlife/adulthood remained significantly associated with higher baseline cognitive function, even after accounting for one another.

DISCUSSION

Findings provide insight into life-course neighborhood contextual influences on cognitive aging. Our results emphasize the need for more research to understand the life-course dynamics between neighborhood environments and cognitive aging.

Perceived Neighborhood Racial Composition and Depressive Symptoms Among Black Americans Across Adulthood: Evaluating the Role of Psychosocial Risks and Resources

Objectives: To evaluate the relationships between perceived neighborhood racial composition (PNRC), psychosocial risks and resources, and depressive symptoms among young (ages 22-35), middle-aged (ages 36-49), and older (ages 50+) Black Americans. Methods: Full sample and age-stratified linear regression models estimated the PNRC-depressive symptoms association and the extent to which it persisted after accounting for psychosocial risks (i.e., neighborhood disorder, other social stressors) and resources (i.e., mastery, social support, racial identity) among 627 Black Americans in the Nashville Stress and Health Study. Results: Living in racially integrated and predominately White neighborhoods was associated with elevated depressive symptoms. While psychosocial risks and resources explained a substantial portion of these associations, patterns varied across age groups. Discussion: PNRC impacts depressive symptoms among Black Americans by shaping psychosocial risks and resources. Findings underscore interconnections between contextual and psychosocial factors, as well as the distinct mental health significance of these processes across stages of adulthood.

Role of Neighborhood Physical Disorder and Social Cohesion on Racial and Ethnic Disparities in Dementia Risk

Objectives: To analyze how neighborhood physical disorder and social cohesion are associated with racial and ethnic disparities in dementia risk. Methods: Nine years of data (2011-2019) were retrieved from the National Health and Aging Trends Study, a nationally representative U.S. older adult (age 65+) sample. Cox regression analyzed time to dementia diagnosis using composite scores for neighborhood physical disorder and social cohesion. Results: Higher baseline neighborhood physical disorder (Adjusted Hazard Ratio [aHR]=1.11, 95% Confidence Interval [CI]=1.01-1.23) and increased disorder at follow-up (aHR=1.10, 95% CI=1.01-1.19) significantly increased dementia risk. Hispanic older adults with higher physical disorder at baseline (aHR=0.62, 95% CI=0.49-0.79) and follow-up (aHR=0.81, 95% CI=0.67-0.98) had a significantly decreased dementia risk. There were no significant associations for social cohesion. Discussion: Physical but not social neighborhood characteristics are associated with dementia risk. Future research is needed to understand protective mechanisms for dementia among Hispanic older adults in neighborhoods with high physical disorder.

Perceived neighborhood and fall history among community-dwelling older adults living in a large Brazilian urban area: a multilevel approach

Few studies have examined the neighborhood features related to falls in the older population in low-and-middle-income countries, including Brazil. This study aimed to evaluate if perceived neighborhood features are related to falls among older Brazilian adults living in a large urban area. This cross-sectional study was conducted using data from 834 participants (≥60 years) from a multistage household survey in Belo Horizonte, Brazil. The association between fall history in the previous year and perceived neighborhood features (quality of services, physical and social disorder, and safety) was examined using multilevel logistic regression. The fall prevalence was 13.6%. Older adults living in neighborhoods with a higher physical disorder were more likely to report fall in the previous year, even after controlling for demographic, clinical and social variables (OR = 2.59; 95% CI = 1.14-5.87). The other neighborhood features investigated were not associated with a fall history. Our findings suggest that improving the physical environment represents an important strategy to prevent falls in the Brazilian urban older population.

Neighborhood Social Cohesion and the Health of Native Hawaiian and Other Pacific Islander Older Adults

Native Hawaiian and other Pacific Islander (NHPI) older adults experience various social and health challenges. There is a growing literature linking neighborhood conditions with health, yet few have focused on NHPI older adults. This study examines associations between neighborhood social cohesion and health outcomes (i.e., self-rated health, psychological distress, and memory) in this population. Data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n=1,045 with respondents aged 50+) were analyzed with logistic regression models. The level of neighborhood social cohesion was determined by responses to items on perceptions of mutual help, dependability, trust, and close relationships within the neighborhood. Higher perceived neighborhood social cohesion was associated with lower odds of having serious psychological distress or memory problems. There was no statistical association of social cohesion with self-rated health. Socially cohesive neighborhoods are important to the health of NHPI. We discuss methods to improve neighborhood social cohesion as a way to promote health equity for NHPI older adults in the United States (U.S.).

The Role of Envy in Linking Active and Passive Social Media use to Memory Functioning

Social media use has previously been shown to have negative implications for cognition. Scarce research has examined underlying pathways through which social media use may influence cognition. One potential pathway involves the consequences of social comparison, such that those who use social media more frequently may feel worse about themselves and more envious toward others. In turn, these negative socioemotional states could compromise memory. Further, whether an individual uses social media actively or passively may moderate these associations. Using an online adult lifespan sample (n=592), the current cross-sectional study examined whether socioemotional consequences of social comparison (self-esteem and envy) mediated relationships between social media use and memory (everyday memory failures and episodic memory) and whether active/passive use moderated these associations. Mediation models revealed that higher envy, but not lower self-esteem, partially explained the relationship between higher social media use and more self-reported everyday memory failures. Neither envy nor self-esteem mediated the relationship between higher social media use and lower objective episodic memory performance. Additionally, higher social media use was associated with higher envy to a greater extent for active users compared to passive users. These findings may suggest that high social media use has negative ramifications for both subjective and objective memory and that increased feelings of envy may partially explain these effects for subjective, but not objective, memory.

Social Relationships and Adaptation in Later Life

Social relations encompass a complex and dynamic set of characteristics that have been shown to distinctly affect health and quality of life across the lifespan and especially in older adulthood. In this chapter we begin with a brief review of several prominent theories of social relations. Next, we consider how social relations can be understood based on the resource they provide (e.g., contact frequency, social support), the relationship they stem from (e.g., friends, family), the strength of the tie (e.g., strong, weak) as well as the means of communication (e.g., offline, online). We briefly summarize how these characteristics have been shown to uniquely influence health and quality of life in older adulthood. Finally, we contemplate potential clinical applications, provide recommendations for the future and offer final concluding comments.

Loneliness mediates the relationships between perceived neighborhood characteristics and cognition in middle-aged and older adults

OBJECTIVES

We aimed to examine whether loneliness mediates these associations between perceived neighborhood characteristics and cognition among middle-aged and older adults.

METHODS

Data from wave 10 (2010-2012) to wave 13 (2016-2017) of the Health and Retirement Study were analyzed. Perceived neighborhood characteristics were self-reported. Loneliness was measured by Revised University of California Los Angeles (R-UCLA) Loneliness Scale. Cognition was evaluated by the modified version of Telephone Interview for Cognitive Status. Baron and Kenny's causal steps and multiple linear regression models based on Karlson/Holm/Breen (KHB) method were used to examine the mediating effect.

RESULTS

At baseline, 15,142 participants had no cognitive impairment, and 11,413 individuals were finally included in our analysis after 6-year follow-up. Multiple linear regression models suggested that lower perceived neighborhood physical disorder (β = 0.073, p = 0.033) and greater perceived neighborhood safety (β = 0.350, p = 0.009) were associated with better cognition. KHB test identified the significant mediating effect of loneliness on the relationships between perceived neighborhood physical disorder (β = 0.011, p = 0.016) and perceived neighborhood safety (β = 0.023, p = 0.026) and cognition.

CONCLUSIONS

Perceived neighborhood characteristics are associated with cognition among middle-aged and older American adults. Loneliness mediated associations between perceived neighborhood physical disorder and perceived neighborhood safety and cognition.

Neighborhood built environment associated with cognition and dementia risk among older adults: A systematic literature review

Cognitive impairment associated with aging is a serious and growing public health problem. This systematic literature review contributes to better understanding the current state of knowledge on the roles of neighborhood environments in supporting cognitive health in later life. Literature search was carried out in 2020 using the seven databases most relevant to the topic. This review was restricted to peer-reviewed observational and quantitative studies that focused on 1) community-dwelling older adults as target populations; 2) neighborhood built environments as independent variables; and 3) cognition or dementia as outcome variables. Thirty-seven studies published between 1989 and 2020 met the inclusion criteria. The neighborhood built environment domains covered in these included urbanity/rurality, land use, neighborhood physical disorder, transportation infrastructure, urban design, and urban nature. Neighborhood resources and green space exposure were most frequently studied and linked to cognition-related outcomes. Neighborhood built environment was shown to be more pertinent to older adults' global cognition, memory, and dementia. Physical activity showed a mediating role between neighborhood built environment and cognition. The effect of neighborhood built environment on cognitive function was stronger among older women and those with disabilities or lower socioeconomic status. Evidence on the relationship between neighborhood built environment and cognition/dementia among older adults is moderate. Our findings highlight the need for more standardized and longitudinal measures of neighborhood built environment and high-sensitivity cognitive tests that capture the specific and relevant domains of cognition, to facilitate further exploration of the mediating and moderating effects of neighborhood built environment with cognition/dementia in older adults. This review offers insights for future research and policy efforts toward creating communities to support cognitive health and aging in place.

Association of Local Variation in Neighborhood Disadvantage in Metropolitan Areas With Youth Neurocognition and Brain Structure

Importance

Neighborhood disadvantage is an important social determinant of health in childhood and adolescence. Less is known about the association of neighborhood disadvantage with youth neurocognition and brain structure, and particularly whether associations are similar across metropolitan areas and are attributed to local differences in disadvantage.

Objective

To test whether neighborhood disadvantage is associated with youth neurocognitive performance and with global and regional measures of brain structure after adjusting for family socioeconomic status and perceptions of neighborhood characteristics, and to assess whether these associations (1) are pervasive or limited, (2) vary across metropolitan areas, and (3) are attributed to local variation in disadvantage within metropolitan areas.

Design, Setting, and Participants

This cross-sectional study analyzed baseline data from the Adolescent Brain and Cognitive Development (ABCD) Study, a cohort study conducted at 21 sites across the US. Participants were children aged 9.00 to 10.99 years at enrollment. They and their parent or caregiver completed a baseline visit between October 1, 2016, and October 31, 2018.

Exposures

Neighborhood disadvantage factor based on US census tract characteristics.

Main Outcomes and Measures

Neurocognition was measured with the NIH Toolbox Cognition Battery, and T1-weighted magnetic resonance imaging was used to assess whole-brain and regional measures of structure. Linear mixed-effects models examined the association between neighborhood disadvantage and outcomes after adjusting for sociodemographic factors.

Results

Of the 11 875 children in the ABCD Study cohort, 8598 children (72.4%) were included in this analysis. The study sample had a mean (SD) age of 118.8 (7.4) months and included 4526 boys (52.6%). Every 1-unit increase in the neighborhood disadvantage factor was associated with lower performance on 6 of 7 subtests, such as Flanker Inhibitory Control and Attention (unstandardized Β = -0.5; 95% CI, -0.7 to -0.2; false discovery rate (FDR)-corrected P = .001) and List Sorting Working Memory (unstandardized Β = -0.7; 95% CI, -1.0 to -0.3; FDR-corrected P < .001), as well as on all composite measures of neurocognition, such as the Total Cognition Composite (unstandardized Β = -0.7; 95% CI, -0.9 to -0.5; FDR-corrected P < .001). Each 1-unit increase in neighborhood disadvantage was associated with lower whole-brain cortical surface area (unstandardized Β = -692.6 mm2; 95% CI, -1154.9 to -230.4 mm2; FDR-corrected P = .007) and subcortical volume (unstandardized Β = -113.9 mm3; 95% CI, -198.5 to -29.4 mm3; FDR-corrected P = .03) as well as with regional surface area differences, primarily in the frontal, parietal, and temporal lobes. Associations largely remained after adjusting for perceptions of neighborhood safety and were both consistent across metropolitan areas and primarily explained by local variation in each area.

Conclusions and Relevance

This study found that, in the US, local variation in neighborhood disadvantage was associated with lower neurocognitive performance and smaller cortical surface area and subcortical volume in young people. The findings demonstrate that neighborhood disadvantage is an environmental risk factor for neurodevelopmental and population health and enhancing the neighborhood context is a promising approach to improving the health and development of children and adolescents.

Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review

BACKGROUND

Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia.

METHODS

A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels.

RESULTS

Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level.

CONCLUSIONS

Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.

The Foreclosure Crisis, Community Change, and the Cognitive Health of Older Adults

OBJECTIVES

While home foreclosures are often thought of as a household-level event, the consequences may be far-reaching, and spill over to the broader community. Older adults, in particular, could be affected by the spiral of community changes that result from foreclosures, but we know very little about how the foreclosure crisis is related to older adult health, in particular cognition.

METHOD

This article uses growth curve models and data from the Health and Retirement Study matched to Census and county-level foreclosure data to examine whether community foreclosures are related to older adults' cognitive health and the mechanisms responsible.

RESULTS

We find that higher rates of county-level foreclosures are associated with a faster decline in individual cognition at older ages. Although we examined an extensive number of individual and community mechanisms, including individual housing wealth and depressive symptoms, community structural factors, social factors, and perceptions of physical disorder and cohesion, none of the mechanisms examined here explained this relationship.

DISCUSSION

This study shows that the adverse consequences of home foreclosures spill over to the local community, with implications for the cognitive health of older adults.

The role of neighborhood stressors on cognitive function: A coordinated analysis

The objective of this study was to evaluate the association between perceived neighborhood stressors, encompassing negative perceived neighborhood characteristics, and specific cognitive abilities in adulthood. We conducted a coordinated analysis across three studies of adults in the United States and found that perceived neighborhood stressors were consistently associated with poorer performance on attention-demanding cognitive tasks. We specifically found that perceived neighborhood stressors were associated with lower performance in spatial abilities, working memory, and executive function but not perceptual speed, and that the effect was most consistent for lower perceived neighborhood safety followed by lower perceived aesthetic quality, greater perceived neighborhood crime, and lower perceived neighborhood cohesion. These results highlight the importance of the psychosocial neighborhood context for cognitive health in adulthood.

Neighbourhood Environment and Cognitive Vulnerability—A Survey Investigation of Variations Across the Lifespan and Urbanity Levels

Background: Understanding the impact of local communities on wellbeing is a paramount Sustainable Development Goal. In order to inform people-centred planning interventions, it is important to understand what demographic groups need supportive communities the most and where. This study explored associations between perceived neighbourhood characteristics and cognitive vulnerability, and the moderating role of age and urbanity of the place of residence. Methods: A convenience sample of 224 Irish adults completed a survey assessing cognitive vulnerability and perceptions of neighbourhood qualities, together with sociodemographic and residential information. Correlational analyses explored bivariate associations as well as moderating effects. A subsample (n = 142) provided qualitative accounts of their preferences of neighbourhood characteristics. Results: Regression analyses showed that controlling for sociodemographic factors, higher self-reported neighbourhood pleasantness was associated with lower cognitive vulnerability, particularly in older adults who lived in the most rural and urban areas (p = 0.006). Qualitative accounts suggested urban–rural variations in perceived accessibility and perceptual stressors, and age-related variations in social preferences. Conclusions: Our findings indicate a complex association between neighbourhood characteristics and cognitive wellbeing, highlighting the potential benefits of neighbourhood pleasantness for cognition particularly for older people in very rural or very urbanised places. Implications for research and environmental interventions are discussed.

The impact of region and urbanicity on the discrimination-cognitive health link among older Blacks

Little research has examined how the link between discrimination and cognitive health varies by where people live. This study investigates how living in non-urban versus urban areas in different regions in the United States moderates the discrimination-cognitive health link among older non-Hispanic Blacks. Data are from the 2012 and 2014 waves of the Health and Retirement Study (HRS; N=2,347). Regression analyses indicate that experiencing more everyday discrimination is significantly associated with lower episodic memory when living in urban areas. Among non-Hispanic Blacks, the discrimination-episodic memory link does not significantly vary across U.S. regional contexts. Findings highlight variation in the association between everyday discrimination and cognitive health by where older non-Hispanic Blacks live. Results suggest the importance of socio-environmental factors in shaping how stressful experiences such as discrimination are linked to cognitive health in later life.

Interactive Effects of Chronic Health Conditions and Financial Hardship on Episodic Memory among Older Blacks: Findings from the Health and Retirement Study

Previous research links chronic health conditions and financial hardship to cognitive outcomes among older Blacks. However, few studies have explored the moderating effect of financial hardship on chronic disease burden and specific cognitive domains. This study examined whether financial hardship (as measured by difficulty paying monthly bills) modifies the impact of self-reported chronic health conditions (e.g., diabetes, stroke) on episodic memory among 871 older Blacks (50+ years) in the Health and Retirement Study (2006). Financial hardship modified the association between chronic disease burden and episodic memory performance such that individuals who reported very little difficulty paying their monthly bills had significantly lower memory scores at high levels of disease burden compared to those reporting high financial difficulty after controlling for age, gender and education (F 2, 49 = 5.03, p= 0.010). This cross-sectional study suggests that both financial and physical wellbeing may have joint effects on cognitive health in older Blacks.

Psychological distress links perceived neighborhood characteristics to longitudinal trajectories of cognitive health in older adulthood

RATIONALE

Perceived neighborhood characteristics have been linked to cognitive health in older adulthood. The pathways through which neighborhood characteristics could influence cognition in older adulthood, however, have not been fully explored. Poorer quality neighborhoods may negatively influence cognition through feelings of psychological distress.

OBJECTIVE

To examine whether perceived neighborhood physical disorder and social cohesion were associated with change in episodic memory and semantic verbal fluency through anxiety and depressive symptoms.

METHODS

Using the Health and Retirement Study (HRS; n = 13,919), mediation models were conducted. Change in cognition (episodic memory and semantic verbal fluency) were modeled using latent growth curve models.

RESULTS

Higher physical disorder was associated with worse initial episodic memory and verbal fluency through greater anxiety symptoms. Higher social cohesion was associated with better initial episodic memory and verbal fluency through both lower anxiety and fewer depressive symptoms. Further, individuals with higher social. cohesion reported lower anxiety and in turn, showed a slower rate of verbal fluency decline. A direct effect of physical disorder on initial episodic memory remained, after accounting for indirect effects and covariates.

CONCLUSIONS

Overall, individuals who live in neighborhoods with high physical disorder and low social cohesion may experience greater psychological distress. Symptoms of anxiety and depression may, in turn, interfere with cognitive functioning. Neighborhood characteristics may be an important, targetable area for intervention to improve not only mental health outcomes, but cognitive health outcomes in older adulthood.

The Area Deprivation Index: A novel tool for harmonizable risk assessment in Alzheimer's disease research

INTRODUCTION

Residence in a disadvantaged neighborhood associates with adverse health exposures and outcomes, and may increase risk for cognitive impairment and dementia. Utilization of a publicly available, geocoded disadvantage metric could facilitate efficient integration of social determinants of health into models of cognitive aging.

METHODS

Using the validated Area Deprivation Index and two cognitive aging cohorts, we quantified Census block-level poverty, education, housing, and employment characteristics for the neighborhoods of 2119 older adults. We assessed relationships between neighborhood disadvantage and cognitive performance in domains sensitive to age-related change.

RESULTS

Participants in the most disadvantaged neighborhoods (n = 156) were younger, more often female, and less often college-educated or white than those in less disadvantaged neighborhoods (n = 1963). Disadvantaged neighborhood residence associated with poorer performance on tests of executive function, verbal learning, and memory.

DISCUSSION

This geospatial metric of neighborhood disadvantage may be valuable for exploring socially rooted risk mechanisms, and prioritizing high-risk communities for research recruitment and intervention.